What Is Knee Pain
Your knee joint has three bones: the lower thighbone , the upper shin bone , and the kneecap . Ligaments and tendons connect these bones and help keep them stable. Cartilage surrounds the ends of the bones, allowing them to move without rubbing against each other. The meniscus, a shock-absorbing cushion, sits between the thigh and shin bones.The synovial membrane, a lining that surrounds multiple surfaces, produces joint fluid to keep the cartilage lubricated. The quadriceps tendon connects the thigh muscle to the kneecap, while the patellar tendon connects the kneecap to the shin bone.
These interconnected parts, which stretch from hip to ankle, work together to allow the knee to bend, straighten, and rotate, explains Cody Anderson, PT, DPT, a physical therapist at Hinge Health. Any disruption to these structures can result in pain when you bend your knee.
Treatment Of Pain At The Front Of The Knee
Whether or not you need further treatment for your knee pain and what treatment you have, will depend on whats causing the pain. Most conditions causing pain at the front of the knee can be treated with painkillers and physiotherapy. Surgery is usually only needed if other treatments havent worked.
For information on treatments, please see the relevant knee condition page.
Your doctor will be able to assess how serious your knee pain is by asking you questions and examining your knee. If necessary, theyll carry out some scans too. You should see a doctor if your symptoms are severe or dont start to improve within a few weeks. For more information on this, see our section on symptoms above.
Pain In The Front Of The Knee: 6 Common Causes
Howard J. Luks, MDUpdated May 23, 2022
Pain in the front of the knee or anterior knee pain is very common. Do any of these scenarios seem familiar to you? You come to a stairway and cringe at the thought of having to walk downstairs. You love to run, but the anterior knee pain you have when running downhill has taken the joy out of running. If youve been sitting for a while, the thought of having to get up is becoming too much to bear. While I could say youre not alone, thats not very comforting. You are here for answers. Lets see how we can help educate you on why the front of your knee hurts so much.
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What Are The Symptoms Of Jumper’s Knee
Following are the most common symptoms of jumper’s knee. However, you may experience symptoms differently. Symptoms may include:
- Pain and tenderness around your patellar tendon
- Pain with jumping, running, or walking
- Pain when bending or straightening your leg
- Tenderness behind the lower part of your kneecap
The symptoms of jumper’s knee may resemble other conditions or medical problems. Always see your healthcare provider for a diagnosis.
Where Does Your Knee Hurt
Knee pain on the front of the jointcould be patellar arthritis or patellar tendonitis. These conditions tend to hurt when bending the knee, kneeling and/or squatting. Typically the deeper the knee bend the worse it will hurt.
The discomfort localized to the medial or inside of the knee could indicate tibiofemoral arthritis or meniscal irritation.
Nagging pain or pressure that is localized to the back of the knee could be a sign that youve damaged your meniscus. It is also possible that you irritated the popliteal muscleand surrounding area.
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Causes Of Knee Pain When Bending
A surprising truth: Just because you feel knee pain does not mean there’s a visible cause. “Studies that have found that X-rays on people experiencing pain often don’t pick up an anatomical injury that explains it,” says Dr. Anderson. He encourages people to worry less about “damage” to the joint and focus more on getting moving again.
In fact, your perspective is part of your treatment, so try to stay positive. “Pain is an alarm system. It’s your body’s way of telling the brain there is an issue that needs some help. It does not mean that the pain won’t get better. If we feed the brain this idea that we’re damaged or broken, we feed the alarm system, making pain worse,” says Dr. Anderson.
That said, knowing what’s causing your knee pain can help you and your healthcare providers determine your treatment. Here are some of the most common reasons you may experience pain while bending the knee:
Patellofemoral syndrome. Nicknamed “runner’s knee,” patellofemoral syndrome accounts for about 25-40% of visits to sports medicine clinics, research shows. You’ll feel pain behind or around the kneecap, which gets worse by movement such as using stairs, squatting, running, jumping or sitting with flexed knees.
Other common causes of knee pain when bending include:
Bone fracture or dislocation. A serious fall or motor vehicle accident could fracture the kneecap or the end of the thigh or shin bone where it meets the knee. It could also force the bones out of alignment.
Recovery Time And Immediate Treatment Exercises
When injured tissues are forced into use too soon they often dont entirely recover. Weakened tendons are far more likely to become reinjured. The more times the same tissue is damaged, the greater the chances of developing long-term damage.
It generally takes people several days to start to feel major relief, and six weeks or more to feel entirely better.
Avoid anything that activates the tendon for the first 48 hours. After that, exercises should only be done if they dont cause additional pain.
In the first week after injury you can start reintroducing slow, steady movements that focus on maintaining general strength. A good starting exercise is isometric knee flexes, where the injured hamstring is placed over the opposite leg and contracted at 30, 60, and 90-degree angles, as comfortable.
Its usually safe to begin range of motion, lengthening, and strengthening exercises after a week or so. An easy starting point is a single leg windmill. To do this exercise:
You can add handheld weights to make the stretch more difficult.
The Nordic hamstring exercise is another useful stretch:
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Diagnosis Of Pain Behind The Knee:
A physical examination is of primary importance in the diagnosis of posterior knee pain caused by injury or arthritis. The doctor will manipulate the legs to check for rotation, flexion, and stability and to determine which movements are causing the pain.
The doctor may also use imaging procedures such as ultrasound, X-ray, CT, arthrography, and MRI. Sometimes the doctor takes fluid from the knee for laboratory testing. A doctor will use a physical exam, lab studies, and imaging if he or she suspects an infection, tumor, or DVT. A doctor can usually diagnose a Bakers cyst by sight but can confirm the diagnosis with an imaging procedure.
Is Surgery Ever Needed For Anterior Knee Pain
In some cases of patella instability, where the kneecap dislocates often we need to consider surgery to reconstruct the ligament which holds the patella in place.
In cases of severe arthritis of the patella, we occasionally need to consider a joint replacement if you do not respond to a compression sleeve, injections, activity modification, and physical therapy.
Patella tendonitis or a jumpers knee will usually respond to activity modification and physical therapy. It is not unusual for your recovery to take up to 6-8 months. If the pain remains severe, there has been a recent interest in trying PRP injections to regenerate the patella tendon. It is still controversial whether or not PRP injections are useful. Surgery, although rarely needed, can be very useful in severe cases of a jumpers knee.
Exercises For Bent Knee Pain
Here are a few gentle exercises from Hinge Health that are commonly used to prevent and treat knee pain. To be safe, ask your healthcare provider if these moves are right for you and your stage of healing.
Sit to Stand
This move uses all the muscles from your hips to ankles and helps the knee be able to bear more weight.This is a good exercise to help you build up to doing squats again. Bonus: Because this engages the hip muscles, it also builds support for a sore lower back.
Standing Hamstring Curl
Hamstring curls strengthen the hamstring muscles that support the knee and help get the knee moving.
Seated Knee Extension
This exercise is particularly good to strengthen the quadricep muscles that support the knee. Bend the knee back as far as you comfortably can to fully engage the muscles and increase the range of motion.
These also work the quadriceps and hips, building support for the lower back as well as the knee.
Causes Of Knee Pain When Bending:
Pain behind knee when bending can be the result of many causes, including arthritis, overuse, or sports injuries. All of these can result in knee pain when bending or activating the knee joint. Some knee discomfort can have a clear cause. For example, if you fell on your knee during an athletic workout, its safe to assume thats why your knee hurts. Other causes of knee pain, such as arthritis or a degenerative condition, will require a clinical evaluation and professional diagnosis.
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Diagnosis Of Pain At The Front Of The Knee
If you see a doctor because of your knee pain, theyll examine your knee and ask you some questions. These may include:
- when your pain started and if theres anything that makes it worse
- whether theres any activity, accident or injury that could have caused it
- whether you have any other symptoms such as your knee giving way or clicking, or pain in any of your other joints
If you have cartilage or ligament damage, your doctor may suggest a procedure to look inside your knee. This is called an arthroscopy . It involves making a small cut in your knee and inserting a thin tube and camera. As well as diagnosing the problem, your doctor may sometimes be able to repair or remove any damaged tissues during the procedure.
Shoes To Help With Knee Pain
Proper footwear is also very important as those who wear flat shoes may be more prone to knee pain when bending as opposed to those who wear shoes with some sort of arch support or lift in them.
The best shoes to wear when youre experiencing knee pain are shoes that are lightweight, have good arch support, and have a slight heel to them.
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Conditions Associated With Pain At The Front Of The Knee
There are several medical conditions linked to pain at the front of the knee. They include the following.
Patellofemoral pain syndrome is one of the most common reasons for pain at the front of the knee. When you bend and straighten your leg, your kneecap slides up and down a groove at the end of your thigh bone . Patellofemoral pain syndrome describes pain related to this joint. It can happen if theres repeated stress on your knee for example, from jogging, squatting or jumping. It can also result from problems with the alignment between your kneecap and thigh bone. Doctors sometimes call it runners knee. It often happens in people who are very active particularly teenagers and young adults.
Patella tendinopathy means the patellar tendon in your knee becomes worn down. This tendon attaches your kneecap to your shin bone, and it can become inflamed and tear. This can be due to overuse and stress over time, particularly in sports that involve jumping like basketball and volleyball. Because of this, its often called jumpers knee. Quadriceps tendonitis is a similar condition but is less common. It causes pain and tenderness where the tendon from your thigh muscle attaches to your kneecap.
Infrapatellar fat pad syndrome is a condition where the fat pad below your kneecap gets pinched between your kneecap and thigh bone. Its usually due to repeated stress on your knee. Its sometimes called Hoffas syndrome.
Who Gets Pfp Syndrome
Patellofemoral pain syndrome usually happens in people who do sports that involve a lot of knee bending and straightening, such as running, biking, and skiing. It also can happen to people, particularly young women, who do not do a lot of sports.
PFP syndrome is more common in women and happens most often to teens and young adults.
Tight or weak leg muscles or flat feet can make someone more likely to get PFP syndrome.
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Most Common Causes Of Knee Pain
Other common causes of knee pain include:
- A dislocated kneecap
- Iliotibial band syndrome burning pain on the outer side of your knee that can spread to your hip or thigh and is caused by inflammation it commonly occurs in runners
- Knee bursitis inflammation of the fluid-filled cushions in your knee joint, which causes swelling, warmth and pain
- Osgood-Schlatter disease a condition that causes pain and swelling at the point where the patellar tendon meets the top of your shinbone
- Osteoarthritis a type of arthritis caused by wear and tear of your joints over time, which causes pain, swelling and stiffness that is worse in the morning
- Patellar tendonitis inflammation of the patellar tendon, which connects your kneecap to your shinbone this causes burning pain just below your kneecap
Iliotibial band syndrome, knee bursitis, runners knee, osteoarthritis and patellar tendonitis can also cause knee pain when bending. Other causes of knee pain when bending include:
Pain behind knee when bending
If your knee pain when bending occurs behind your knee, the most likely causes are a Bakers cyst, hamstring tendonitis or a knee injury.
Sharp pain in knee when bending
If your knee pain when bending is sharp, the most likely causes are a torn ligament or meniscus, fracture of one of the bones of your knee joint, osteoarthritis or patellar tendonitis.
Pain at the top of kneecap when bending
Rice: Rest Ice Compress Elevate
RICE is an acronym for rest, ice, compress, and elevate. This treatment is beneficial for minor muscle injuries, including knee pain. When youre experiencing knee pain, you can rest and avoid putting pressure on your knee. Then, wrap ice in a clean cloth and apply to your knees for 20 minutes, multiple times a day. Later on, you can try compressing your knee by snuggling it with an elastic bandage. But make sure not to make it too tight. If your knees are swelling, elevate them higher than your heart. With this method, you can help remedy most mild knee pain.
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Painful Knee: Where Does It Hurt
The exact location of your knee pain is an indicator of the cause. Your doctor will ask you to describe in detail the exact location and type of pain you experience in the knee. This can help the doctor determine the type of condition or injury responsible for your symptoms. Below are some possible causes of knee pain.
Patellar Tendonitis Usually, pain in the front of the knee is caused by a problem with the patellar tendon. Patellar tendonitis is a type of overuse injury. Running, jumping, a sudden increase in the intensity of an activity, muscular tightness, and imbalance can contribute to this injury. With this condition, it can hurt to bend the knee, kneel, and squat.
Iliotibial Band Syndrome Pain on the outside or lateral side of the knee usually indicates a problem with the iliotibial band or the lateral meniscus . Iliotibial band syndrome is common in long-distance runners, as well as cyclists and rock climbers. The repetitive bending of the knee can lead to this condition. Meniscus tears, on the other hand, are caused by sudden twisting movements of the knee, which is common in basketball, football, soccer, and tennis players.
Other Causes Pain in the back of the knee could mean different things: a cartilage injury, a ligament injury, a hamstring injury, Bakerâs cyst , and arthritis. There are many possible causes of pain in the back of the knee, which is why it should be evaluated by an experienced medical professional.
Knee Pain When Bending
Reviewed by: KPE Medical Review Board
Knee pain when bending is a common problem. Forces up to seven times body weight can go through the knee as it bends, so it comes as no surprise that it is such a widespread problem.
Bending knee pain may start suddenly after an injury, or gradually come on over time depending on the cause.
There are a number of different causes of knee pain when bending, but they generally all result from a problem with one of the structures in or around the knee, affecting how it moves.
This changes how the forces travel through the different parts of the knee and can result in too much pressure going through certain parts, which leads to knee pain bending.
Here we will look at the different types of bending knee pain, the most common causes of knee pain when bending, treatment options and what is actually going on in the knee as it bends.
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